{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T04:56:41Z","timestamp":1790571401838,"version":"4.1.0"},"reference-count":50,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T00:00:00Z","timestamp":1790467200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T00:00:00Z","timestamp":1790467200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["acamh.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Child Psychology Psychiatry"],"abstract":"\n Background<\/jats:title>\n Circle of Security\u2010Parenting (COSP) is one of the most popular attachment\u2010based preventive support programs for parents and children. More than 50,000 participants from different (para)professional disciplines have been trained in the formal COSP\u2122 protocol.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n In a preregistered meta\u2010analysis and synthesis of all eight randomized trials (\n N<\/jats:italic>\n \u2009=\u20091,094 families), we examined COSP's efficacy on caregivers'\n parenting<\/jats:italic>\n (sensitive parent\u2013child interactions, reflective functioning, and parenting attitudes), on\n parent<\/jats:italic>\n mental health outcomes (stress, depression, and anxiety), and on\n child<\/jats:italic>\n attachment security and behavior problems.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n We found an overall nonsignificant effect size of Cohen's\n d<\/jats:italic>\n \u2009=\u20090.142 (\n SE<\/jats:italic>\n \u2009=\u20090.089;\n p<\/jats:italic>\n \u2009=\u2009.154, 95% Confidence Interval \u22120.068, 0.353, 95% Prediction Interval \u22120.444, 0.729), in a homogeneous set of studies. The pooled effect sizes of the parenting, parent, and child domains did not differ from each other or from zero. Cluster\u2010robust inference tests showed converging (nonsignificant) results. The majority of the randomized studies (82%) were identified with some concerns about risk of bias.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n We conclude that the evidence for COSP efficacy does not keep pace with the uptake of COSP in professional practice and policy.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/jcpp.70240","type":"journal-article","created":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T04:35:18Z","timestamp":1790570118000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Research Review: No robust effects of Circle of Security\u2010Parenting (\n COSP<\/scp>\n ) on parenting, parents, or children \u2013 a systematic review and meta\u2010analysis of randomized controlled trials"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7763-0711","authenticated-orcid":false,"given":"Marian J.","family":"Bakermans\u2010Kranenburg","sequence":"first","affiliation":[{"name":"William James Center for Research ISPA University Institute of Psychological, Social and Life Sciences Lisbon Portugal"},{"name":"Facultad de Psicolog\u00eda y Humanidades Universidad San Sebasti\u00e1n Valdivia Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3909-1918","authenticated-orcid":false,"given":"Megan","family":"Galbally","sequence":"additional","affiliation":[{"name":"School of Clinical Sciences Monash University Clayton Vic. Australia"},{"name":"Monash Health Clayton Vic. Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0735-3186","authenticated-orcid":false,"given":"Erinn","family":"Hawkins","sequence":"additional","affiliation":[{"name":"School of Applied Psychology Griffith University Southport Qld Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1144-454X","authenticated-orcid":false,"given":"Marinus H.","family":"van IJzendoorn","sequence":"additional","affiliation":[{"name":"Research Department of Clinical, Education and Health Psychology UCL University College London London UK"},{"name":"Department of Psychiatry, Faculty of Medicine, Nursing and Health Sciences Monash University Melbourne Vic. Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,27]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"crossref","DOI":"10.1186\/s12889-025-25712-7","article-title":"Effectiveness of the Circle of Security Parenting program in reducing children's behavioral challenges and parental stress, anxiety, and depression in a Saudi Arabian sample","volume":"26","author":"Alwahibah S.","year":"2026","journal-title":"BMC Public Health"},{"key":"e_1_2_13_3_1","volume-title":"Common mistakes in meta\u2010analysis and how to avoid them","author":"Borenstein M.","year":"2019"},{"key":"e_1_2_13_4_1","doi-asserted-by":"crossref","first-page":"651","DOI":"10.1017\/S0954579417000244","article-title":"Circle of security\u2013parenting: A randomized controlled trial in head start","volume":"29","author":"Cassidy J.","year":"2017","journal-title":"Development and Psychopathology"},{"key":"e_1_2_13_5_1","unstructured":"Circle of Security International. (2025).Overview of Circle of Security Parenting (COS\u2010P). Available from:https:\/\/www.circleofsecurityinternational.com\/blogs\/resources\/overview\u2010of\u2010circle\u2010of\u2010security\u2010parenting\u2010cosp[last accessed 25 January 2026]."},{"key":"e_1_2_13_6_1","doi-asserted-by":"crossref","DOI":"10.1186\/s40359-026-04068-6","article-title":"Acceptability of Circle of Security\u2010Parenting groups in NHS community perinatal mental health services in England: Parent and practitioner perspectives","volume":"14","author":"Darwin Z.","year":"2026","journal-title":"BMC Psychology"},{"key":"e_1_2_13_7_1","doi-asserted-by":"crossref","first-page":"504","DOI":"10.1007\/s10826-023-02710-0","article-title":"Circle of Security\u2010Parenting randomized waitlist control study: Change in reflective functioning explains positive caregiver behavior","volume":"33","author":"Dexter C.A.","year":"2024","journal-title":"Journal of Child and Family Studies"},{"key":"e_1_2_13_8_1","doi-asserted-by":"crossref","first-page":"767","DOI":"10.1111\/j.1540-4560.2006.00486.x","article-title":"Developing evidence\u2010based interventions for foster children: An example of a randomized clinical trial with infants and toddlers","volume":"62","author":"Dozier M.","year":"2006","journal-title":"Journal of Social Issues"},{"key":"e_1_2_13_9_1","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1111\/j.0006-341X.2000.00455.x","article-title":"Trim and fill: A simple funnel\u2010plot\u2010based method of testing and adjusting for publication bias in meta\u2010analysis","volume":"56","author":"Duval S.","year":"2000","journal-title":"Biometrics"},{"key":"e_1_2_13_10_1","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1136\/bmj.315.7109.629","article-title":"Bias in meta\u2010analysis detected by a simple, graphical test","volume":"315","author":"Egger M.","year":"1997","journal-title":"BMJ"},{"key":"e_1_2_13_11_1","doi-asserted-by":"crossref","first-page":"572","DOI":"10.1002\/anzf.1193","article-title":"Circle of security intervention for parents of children with autism spectrum disorder","volume":"37","author":"Fardoulys C.","year":"2016","journal-title":"Australian and New Zealand Journal of Family Therapy"},{"key":"e_1_2_13_12_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1080\/14616734.2020.1840762","article-title":"Attachment goes to court: Child protection and custody issues","volume":"24","author":"Forslund T.","year":"2022","journal-title":"Attachment & Human Development"},{"key":"e_1_2_13_13_1","doi-asserted-by":"crossref","first-page":"832","DOI":"10.1016\/S2215-0366(20)30337-0","article-title":"Comment: From attachment to mental health and back","volume":"7","author":"Galbally M.","year":"2020","journal-title":"The Lancet Psychiatry"},{"issue":"1","key":"e_1_2_13_14_1","doi-asserted-by":"crossref","first-page":"S401","DOI":"10.1192\/j.eurpsy.2025.839","article-title":"Circle of Security (COSP) implementation in a public clinical setting in Spain","volume":"68","author":"Garc\u00eda Murillo L.","year":"2025","journal-title":"European Psychiatry"},{"key":"e_1_2_13_15_1","unstructured":"Han R.C.(2023).A randomized controlled trial comparing PCIT\u2010Toddler Circle of Security and waitlist controls to improve child and caregiver emotion regulation. Doctoral dissertation\/graduate thesis West Virginia University.https:\/\/researchrepository.wvu.edu\/etd\/12020"},{"key":"e_1_2_13_16_1","unstructured":"Harrer M. Cuijpers P. Furukawa T. &Ebert D.D.(2019).dmetar: Companion R package for the guide \u201cDoing meta\u2010analysis in R\u201d. 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Cooper G. Hoffman K. &Powell B.(2000).Attachment\u2010based intervention with at\u2010risk Head Start child\u2013parent dyads. [Conference presentation]. National Head Start Research Meetings Washington DC United States."},{"key":"e_1_2_13_23_1","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1080\/14616730252982491","article-title":"The Circle of Security project: Attachment\u2010based intervention with caregiver\u2013pre\u2010school child dyads","volume":"4","author":"Marvin R.","year":"2002","journal-title":"Attachment & Human Development"},{"key":"e_1_2_13_24_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.ridd.2025.105124","article-title":"A systematic review of the efficacy of Circle of Security for parents of children with a developmental delay or intellectual disability","volume":"166","author":"McBride C.","year":"2025","journal-title":"Research in Developmental Disabilities"},{"key":"e_1_2_13_25_1","article-title":"An attachment\u2010based program for parents of youth with clinically significant mental health problems: Scaling up and drilling down to mechanisms of change","volume":"5","author":"Moretti 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mothers after the Circle of Security\u2013Intensive intervention on the social\u2010emotional development of three\u2010year\u2010old children","volume":"396","author":"Ramsauer B.S.","year":"2026","journal-title":"Journal of Affective Disorders"},{"key":"e_1_2_13_34_1","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1111\/sjop.12419","article-title":"Adding \u201cCircle of Security\u2013Parenting\u201d to treatment as usual in three Swedish infant mental health clinics: Effects on parents' internal representations and quality of parent\u2013infant interaction","volume":"59","author":"Risholm Mothander P.","year":"2018","journal-title":"Scandinavian Journal of Psychology"},{"key":"e_1_2_13_35_1","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1037\/met0000300","article-title":"Evaluating meta\u2010analytic methods to detect selective reporting in the presence of dependent effect sizes","volume":"26","author":"Rodgers 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